Latitude News Exclusive: Inside Syria’s medical emergency

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The once white tents stretch up and over the hill as far as the eye can see. This Syrian refugee camp sits so close to the border, it is practically finger-touching distance from Turkey. Three days of pouring rain has created a wet landscape of small lakes and tiny streams running between the tents. Children crouch with buckets, playing in the muddy water, covered in a thin layer of mud from head to toe, whilst their mothers carry overflowing laundry baskets to the designated washing area — a demoralizing cycle of trying to stay clean in a place only conducive to being dirty.

This is Atmeh refugee camp, now home to 13,000 internally displaced people, most of whom fled the town of Idlib after attacks from air strikes and ground shelling. Standing at the camp entrance, I spot the border watch tower from the Turkish side, overlooking this menagerie of forgotten misery. It’s hardly surprising that the camp formed at this point. Any airstrike here could almost be deemed as an attack on Turkey itself; it’s that close. Indeed a month ago, an airstrike on another refugee camp, near Bab-al-Hawa, again not far from the border, rallied the Turkish government into lining up their own defenses along the border.

I am in North Syria with Dr. Rola, a British Syrian doctor and medical co-ordinator of the UK-registered charity, Hand in Hand Syria. She is taking me there to show me the camp’s medical center.

Rola and I met at a Royal Society of Medicine event in London last year. I had been speaking about healthcare in Libya during and after the conflict (stories I reported for Latitude News at the time). She wanted to tell me about what was going on in Syria – she spoke about an appalling humanitarian crisis developing and her frustration at not being able to attract interest from those agencies that exist to step in at times like these.

We met a number of times. At each meeting the picture she painted got bleaker and bleaker. She spoke about a refugee camp forming, swelling in numbers and appalling conditions: Atmeh. Privately I was sure that “someone” would step in to help. But no one did. It is still being left to dedicated volunteers like Rola and her team. So it was time to go and see for myself.

Abandoned by the world

The north is now in the hands of the Free Syrian Army, but the risk from Assad’s airstrikes remain. I looked skywards at every rumble.

Hussein, 27, is a tall, smartly dressed young man who had picked me up at a Turkish airport the night before, quizzed me about opinions towards Syria in the West as we drove to the Hand in Hand office. He had left Damascus the previous week, where he lived with his family and worked in IT. He had come to help the refugees.

I explained that most people are shocked that the leader of a country can kill so many of his own people, but that it was difficult to get up to date information because of the dangers involved for outside media. According to a report by the Committee to Protect Journalists, 28 journalists have been killed by both sides since the uprising began and the number of those kidnapped is rising.

Hussein felt it unfair that Western governments together with NATO had held back in a way they had not in Libya. There may be other political layers to the Syria situation, but that does not soften the feeling of neglect on the ground.

Atmeh (Saleyha Ahsan)

Children wearing sandals come to speak to us. I shiver in my heavy boots and thick jacket. The air feels damp and cold and yet the children stand there smiling in their thin muddy layers, practicing broken English. The odd combinations of clothes indicated the speed at which their mothers had packed as they fled airstrikes hitting their villages.

Mohammed, a young man in his 20’s from Idlib, pulls out his mobile phone. As an English speaker, he has found a position for himself as an interpreter, working with the trickle of journalists that make it here.

“All my street was destroyed, and here is the unexploded bomb that landed on my house,” he says.

He shows me a picture of an explosive device sitting intact on a pile of rubble that was once his home. Now he, his mother, father and three sisters are living in a tent. He shows me another picture, this time of them huddled together in their new home.

Dismal conditions in exile

Rola greets health workers at the medical center. She asks about the condition of a badly injured woman being cared for in a Turkish hospital, the same woman Sarab Al-Jijakli wrote about in his piece for Latitude News last week. The mother had lit a candle to illuminate her tent — there is little access to electricity and generators. The tent caught fire, quickly going up in flames. Her two children died in the blaze and now she is in intensive care in Turkey with 70 percent of her body covered in burns. Such is the misery here in Atmeh.

The medical center is a small huddle of porta-cabins with a consultation room and a moderately stocked, organized pharmacy. It has not always been this way, explains Rola. It is only thanks to small grassroots NGOs like HIH working together with other medical agencies — in this case, the International Medical Corps — that there is a pharmacy at all. During the day, two doctors are on duty. At night it’s one nurse. The medical center is stretched to its limit dealing with primary care issues for 13,000 internally displaced refugees with no specialty input.

Obstetric support, for example, is limited to the nearest facility, a private hospital in Aleppo, two hours away. Many families cannot afford to pay and the journey is dangerous. Consultant obstetrician, Dr. Aisha, who left her Aleppo home to find a safer place for her family, is their only option. She and her husband and their five children used the last of their money to buy a small house – escaping the misery of camp life. Money is exceptionally tight especially because her husband is not working. However, her skills are desperately needed and for the last three months she has been delivering babies on her kitchen table or living room floor in the dark. The village has not had electricity for a few weeks and they can’t afford a generator. And yet the hospitality we received was humbling, with a feast conjured up to welcome us into their home.

HIH is building an extension to her house, moving the delivery suit to a more clinically appropriate setting. I asked her what happens when there is a complication in delivery and the road to is too dangerous to travel on.

The pharmacy at Atmeh (Saleyha Ahsan)

“Then it is a problem,” she said, and fell silent. The responsibility of safe delivery will sit heavily on her shoulders, no doubt.

The reality of this revolution strikes us at the Turkish border. A civilian woman shot in the head in Aleppo and two injured fighters are being rushed in an ambulance to Turkey. Jumping into the back of the ambulance, Rola administers pain medicine as the Turkish border guards coordinate letting the paramedics through to the Syrian side to retrieve the casualties. Their fluorescent uniforms and critical-care-equipped van just a few feet across the border are a welcome sight amongst the confusion and poor resources.

As we prepare to leave Syria, Rola gets a call. A town called Hamah, four hours drive away, has been heavily hit resulting in a mass movement of up to 1,000 people heading towards Atmeh. They are traveling through the bitterly cold night to secure some protection against airstrikes, but there will be nowhere to accommodate them when they arrive. Rola got back onto her persistently ringing phone to find a solution.

“They will be sleeping on the mosque floor until we can work out what to do,” she explained. Rola is frustrated by the lack of international support for an ever-evolving situation.

“Medicine in Syria has now gone back to pre-Crimean War days and we need a Florence Nightingale to help us,” she says as she watches the injured being driven away into Turkey.

Dr. Aisha’s and Hussein’s real names are not given to protect their identities. Only Dr. Rola’s first name is used to protect her identity.

Saleyha Ahsan is a filmmaker, freelance journalist and practicing medical doctor based in the UK. She began her reporting career with the BBC, making a radio documentary from the inside of a Mujahideen training camp in Kashmir, days after 9/11. She has pursued stories from conflict zones ever since but also focuses on issues related to civil liberties. Prior to medicine and the media, Saleyha was a captain in the British Army and served in Bosnia with SFOR.